A local hospital is working to make labor and delivery safer for newborns and their mothers nationwide.
Summa Health System’s Akron City Hospital is one of 14 hospitals across the country participating in the “Perinatal Safety Initiative.”
The project was launched in 2008 to develop national standards to eliminate preventable injuries and deaths during births, particularly those that are induced or helped along with drugs or forceps and/or vacuum procedures.
The program is run through Premier, a group-purchasing and information-sharing alliance that serves 2,700 hospitals and health systems nationwide.
By following recommended standards, boosting communication and preparing for emergencies through simulation training, the participating hospitals reduced newborn birth injuries from 1.8 per 1,000 to 1.4 per 1,000 by 2010, Premier announced last week.
The national target rate for newborn birth trauma set by the federal Agency for Healthcare Research and Quality is 2.3 per 1,000 deliveries.
The rate of babies getting too little oxygen also decreased from 1.6 per 1,000 births to 1.2 per 1,000 at the participating hospitals.
Premier estimates 30 birth injuries were prevented at the 14 hospitals as a result of the improvements.
“While serious adverse events don’t often happen and they are rare, when they do they are devastating,” Premier President and Chief Executive Susan DeVore.
Akron City Hospital is the only Northeast Ohio facility participating in the initiative. The hospital averages 3,000 births a year.
The hospital’s labor-and-delivery staff has worked to adopt the recommendations and improve communication, said Dr. Angela Silber, chief of the Division of Maternal-Fetal Medicine at Summa.
“We have been doing a lot of work in simulation and trying to rehearse situations that come our way,” she said. “In the past, it used to be very segmented.”
Several months ago, the hospital started a “Code C” protocol that calls for quick teamwork when a doctor decides a C-section is needed to make sure it begins within 30 minutes.
‘Code C’ in action
In Donna Delvaux’s case, Silber initiated a “Code C” when the Portage County woman’s contractions intensified while she was being monitored in the hospital.
Delvaux was brought to City Hospital via ambulance from Robinson Memorial Hospital late last month after her water broke nearly seven weeks before her due date.
After several days, Silber became concerned Delvaux and the baby, who was positioned feet-first, were at risk for an umbilical cord prolapse. The baby’s heart rate was dropping, indicating possible distress.
Minutes later, Delvaux was whisked into the operating room.
“Once the decision was made, everybody sprung into action,” Delvaux said. “Everybody was great at telling me what was going on. That’s a huge deal when you’re there and scared and you don’t know what’s happening.”
Her husband, Robby, arrived just moments before their second child was delivered without any complications via C-section.
Reagan, who weighed 4 pounds, 5 ounces at birth, is growing bigger each day in the Akron Children’s Hospital neonatal intensive-care unit at City Hospital. Her parents hope to bring her home soon so she can spend the holidays with her 2-year-old sister, Ellie.
“Everybody seemed to know what to do next and what the plan was,” Delvaux said. “They were wonderful.”
Steps to follow
Summa and other hospitals in the national safety program follow specific steps, called “care bundles,” for labor and delivery situations.
For labor induced by drugs, for example, babies must be at least 39 weeks of gestation. In addition, fetal heart rate must be monitored; pelvic assessment must be performed to ensure the position of the baby and the readiness of the mother for birth; and monitoring must be provided to make sure the mother’s body isn’t overreacting to the drug.
At City Hospital, elective deliveries before 39 weeks gestation have been eliminated for 31 consecutive months, said Tiffany Kenny, Summa’s informatics administrator for Women’s Health Services.
Medical studies are providing growing proof that babies born before 39 weeks have higher rates of breathing problems, low blood sugar, neonatal intensive-care unit stays and serious infections.
The percentage of low-risk, first-time mothers undergoing cesarean sections at City Hospital also decreased from almost 30 percent in 2009 to 24.7 percent in 2010.
And only 17 patients had labor induced when their cervix wasn’t ready during the first half of this year, compared to 40 during the same time period in 2010, Kinny said. Summa loses an average $2,600 each time it cares for a newborn and mother when labor is induced before the cervix is ready.
“More importantly,” Kenny said. “It’s just the right thing to do for our women and infants.”
Cheryl Powell can be reached at 330-996-3902 or email@example.com. Follow Powell on Twitter at twitter.com/abjcherylpowell.